Individual provider Active NPI

Carol Pretorius, MA, LPC

  • Mental Health Counselor
  • Mansfield, OH
National Provider Identifier
1740633452
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.1400379 Issued in OH
Practice address
680 Park Ave W
Mansfield, OH 44906-3706
Phone
(419) 528-5993
Fax
(567) 560-5483
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1400379 OH Primary

Addresses

Primary practice location

680 Park Ave W
Mansfield, OH 44906-3706

Mailing address

680 Park Ave W
Mansfield, OH 44906-3706
Phone (419) 528-5993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C.1400379OHMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1740633452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993",
            "fax_number": "567-560-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993",
            "fax_number": "567-560-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETORIUS",
        "first_name": "CAROL",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1400379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.